Pilates Ate a Breast Implant

This is reason #137 that we don't quite trust Pilates. (Yes, we know, some swear by it, but when we work out, we want to do more than make those weird little flappy motions with our hands, and "make a corset with our ribs," not to mention, there's the distinct sense that we're doing it all wrong.) In any case, a 59-year-old woman who'd had breast cancer and a bilateral mastectomy, and had gone on to get breast implants, was in a Pilates class. She was doing the "Valsalva maneuver," which involves "moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut."

Fortunately, perhaps weirdly, there was no chest pain or shortness of breath. The implant apparently went through a preexisting scar from her right mastectomy.

The NEJM explains, technically:

During a Valsalva maneuver, a circumscribed area of the patient's right anterior chest ballooned outward. Bedside ultrasonography revealed lung herniation through a disrupted intercostal space. Posteroanterior and lateral chest radiographs showed elevation of the right hemidiaphragm. Computed tomography confirmed the intrathoracic position of the prosthesis within the pleural space.

The woman was operated on and had the implant extracted and repositioned. The "unstable intercoastal space" in her chest was repaired.

A doctor whom MSNBC spoke to explained, "What likely happened in this instance is that the breast implant was placed under the chest muscle and on top of the ribs, an extremely common practice in breast reconstruction. When the patient Valsalva'd, the pectoralis (chest) muscle likely contracted and pushed the implant through the space between her ribs" (fragile due to the surgery).

Fear not: This is not a common enough occurrence (in fact, it's sort of a freak incident) to make Pilates lovers stay away from their beloved craft, but still...

Valsalva breathing is really contra-indicated by most certified pilates instructors. It is a bearing down and bracing move that is completely the opposite of the kind of breathing and core strengthening that pilates encourages. I hope this woman finds a better instructor!

Do some fact checking indeed. Are you ok with ending your articles with "but still . . . " But still what? A freak incident. Doing an NON PILATES breathing exercise. I'd like to know if you have ever experienced pilates.